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Indications and Limitations of Coverage

Effective January 1, 2001, augmentative and alternative communication devices or communicators which are hereafter referred to as “speech generating devices” are now considered to fall within the durable medical equipment (DME) benefit category established by §1861(n) of the Social Security Act (the Act). They may be covered if the Medicare Administrative Contractor medical staff determines that the patient suffers from a severe speech impairment and that the medical condition warrants the use of a device based on the following definitions.

Definition of Speech Generating Devices

Speech generating devices are defined as speech aids that provide an individual who has a severe speech impairment with the ability to meet his functional speaking needs. Speech generating devices are characterized by:

Being a dedicated speech device, used solely by the individual who has a severe speech impairment;

May have digitized speech output, using prerecorded messages, less than or equal to 8 minutes recording time;

May have synthesized speech output which requires message formulation by spelling and device access by physical contact with the device-direct selection techniques;

May have synthesized speech output which permits multiple methods of message formulation and multiple methods of device access; or

May be software that allows a laptop computer, desktop computer or personal digital assistant (PDA) to function as a speech generating device.

Devices that would not meet the definition of speech generating devices and therefore, do not fall within the scope of §1861(n) of the Act are characterized by:

Devices that are not dedicated speech devices, but are devices that are capable of running software for purposes other than for speech generation, e.g., devices that can also run a word processing package, an accounting program, or perform other than non-medical function.

Laptop computers, desktop computers, or PDA’s which may be programmed to perform the same function as a speech generating device, are noncovered since they are not primarily medical in nature and do not meet the definition of DME. For this reason, they cannot be considered speech-generating devices for Medicare coverage purposes.

A device that is useful to someone without severe speech impairment is not considered a speech-generating device for Medicare coverage purposes.